Efficacy of narrow-band imaging for detecting intestinal metaplasia in adult patients with symptoms of dyspepsia

Sobrino-Cossío, Sergio; Francis, Juan Miguel Abdo; Emura, Fabián; Galvis-García, E.S.; Rocha, M.L. Márquez; Mateos-Pérez, G.; González-Sánchez, C.B.; Uedo, Noriya

doi:10.1016/j.rgmxen.2018.03.009

Cited by 12 publications

(16 citation statements)

References 38 publications

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“…This can adversely affect the comparability among the studies. It was also noted that three studies used magnification with NBI, which can also improve the GIM detection rate 17,18,36 . However, pooled estimates did not show any significant benefit on sensitivity analysis of NBI with magnification only ( P = 0.05).…”

Section: Discussionmentioning

confidence: 97%

“…The performance of high definition WLE is expected to be better than that of standard‐definition WLE for both GIM and dysplasia. Five studies used standard definition WLE, 14,16,18,26,36 three studies used high definition WLE, 21–23, and one study used both standard and high definition WLE for GIM 15 . Similarly, two studies included in dysplasia analysis used both standard and high definition WLE 28,29 .…”

Section: Discussionmentioning

confidence: 99%

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Narrow band imaging for detection of gastric intestinal metaplasia and dysplasia: A systematic review and meta‐analysis

Desai

Boregowda

Srinivasan

et al. 2021

J of Gastro and Hepatol

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Background and Aims: Gastric intestinal metaplasia (GIM), a precursor of gastric adenocarcinoma, is challenging to diagnose with white light endoscopy (WLE) and can be missed by random gastric biopsies. Narrowband imaging (NBI) may potentially improve the detection of GIM. However, pooled estimates from prospective studies are lacking. Methods: Electronic databases were searched for studies comparing NBI and WLE alone for detection of GIM and synchronous dysplasia. Primary outcome was pooled detection rate of GIM by NBI compared with WLE in prospective studies. The secondary outcome was concurrent dysplasia detection. Results: Ten studies were found eligible from 306 articles screened. Eight prospective studies were found eligible for primary endpoint of GIM detection. Two other retrospective studies were included for dysplasia detection. A total of 1366 subjects (694 males, 54.4 ± 5.08 years) underwent upper endoscopy. GIM was detected in 482 (35.3%) subjects. NBI detected GIM in 32% additional subjects (70% vs 38%, RR 1.79; 95% CI 1.34-2.37; P < 0.01). Subgroup analysis revealed newer NBI scopes (GIF260) detected significantly more GIM than WLE (RR 2.47; 95% CI 1.63-3.76; P < 0.01) but not the older (H180) NBI endoscopes (RR 1.33; 95% CI 0.93-1.88; P = 0.11). There was moderate heterogeneity between the studies (I 2 = 63%). In five studies (n = 628) that reported dysplasia, there was no significant difference between NBI and WLE in dysplasia detection (RR 1.09; 95% CI 0.81-1.47; P = 0.58). Conclusion:Narrowband imaging can significantly increase the detection of GIM when used in addition to standard white light exam during an upper endoscopy.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Narrow band imaging for detection of gastric intestinal metaplasia and dysplasia: A systematic review and meta‐analysis

Desai

Boregowda

Srinivasan

et al. 2021

J of Gastro and Hepatol

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“…GIM: Fourteen studies reported their results regarding GIM [9,[14][15][16][17][18][19][20][21][22][23][24][25][26]. ▪ Per-patient analysis: the pooled sensitivity and specificity from the six studies included were 0.…”

Section: Nbimentioning

confidence: 99%

“…Narrow-band imaging (NBI) Yes LBC: a fine blue-white line on the crest of the epithelial surface/gyri [15] MTB: an enclosing white turbid band on the epithelial surface/gyri [15] Oval or tubulovillous pit with clearly visible coiled or wavy vessels [14] LBC: a fine blue-white line on the crest of the epithelial surface/gyri [15,17,21,26] MTB: an enclosing white turbid band on the epithelial surface/gyri [15] Ridge/tubulovillous mucosal pattern [16,17] Oval or tubulovillous pit with clearly visible coiled or wavy vessels [14,23] WOS: a white substance that renders the subepithelial vasculature of the intervening part surrounded by crypt openings opaque [21] VS classification: irregular microsurface and/or microvascular pattern within a demarcation line [27,28,30,[32][33][34][36][37][38][39][40][41][42] Demarcated lesions with a disappearance of fine mucosal structure, microvascular dilation and microvascular heterogeneity in shape [29] Obscure irregular microsurface or microvascular pattern / no microsurface pattern and sparse microvascular or avascular areas [31] Demarcated lesions with disappearance of normal pit pattern and appearance of new vessels [17] No Ridge/tubulovillous mucosal pattern [9, 18-20, 24, 25] LBC with different definitions: A fine, blue-white line on the crests of the epithelial surface [9,18,24] Blue-whitish slightly raised areas [9,20] LLC: a combination of linear dark and light areas that differed from the normal gastric epithelium …”

Section: Use Of High Magnificationmentioning

confidence: 99%

Image-enhanced endoscopy for gastric preneoplastic conditions and neoplastic lesions: a systematic review and meta-analysis

et al. 2020

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Background Image-enhanced endoscopy (IEE) improves the accuracy of endoscopic diagnosis. We aimed to assess the value of IEE for gastric preneoplastic conditions and neoplastic lesions. Methods Medline and Embase were searched until December 2018. Studies allowing calculation of diagnostic measures were included. Risk of bias and applicability were assessed using QUADAS-2. Subgroup analysis was performed to explore heterogeneity. Results 44 studies met the inclusion criteria. For gastric intestinal metaplasia (GIM), narrow-band imaging (NBI) obtained a pooled sensitivity and specificity of 0.79 (95 %CI 0.72–0.85) and 0.91 (95 %CI 0.88–0.94) on per-patient basis; on per-biopsy basis, it was 0.84 (95 %CI 0.81–0.86) and 0.95 (95 %CI 0.94–0.96), respectively. Tubulovillous pattern was the most accurate marker to detect GIM and it was effectively assessed without high magnification. For dysplasia, NBI showed a pooled sensitivity and specificity of 0.87 (95 %CI 0.84–0.89) and 0.97 (95 %CI 0.97–0.98) on per-biopsy basis. The use of magnification improved the performance of NBI to characterize early gastric cancer (EGC), especially when the vessel plus surface (VS) classification was applied. Regarding other technologies, trimodal imaging also obtained a high accuracy for dysplasia (sensitivity 0.93 [95 %CI 0.85–0.98], specificity 0.98 [95 %CI 0.92–1.00]). For atrophic gastritis, no specific pattern was noted and none of the technologies reached good diagnostic yield. Conclusion NBI is highly accurate for GIM and dysplasia. The presence of tubulovillous pattern and the VS classification seem to be useful to detect GIM and characterize EGC, respectively. These features should be used in current practice and to standardize endoscopic criteria for other technologies.

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“…Depending on the preferred diagnostic methods and countries, the prevalence of IM ranges from 7.1 to 42.5% [26][27][28] . Although endoscopy is the major diagnostic method for AG and IM, the narrow-band imaging (NBI), for the endoscopic diagnosis of AG and IM [30][31][32] . However, the examination of the entire stomach can be difficult and time consuming with NBI or ME.…”

Section: Introductionmentioning

confidence: 99%

The Accuracy of Endoscopic Diagnosis of Intestinal Metaplasia Compared to Histopathological Diagnosis

Beştaş¹

2020

jamp

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Intestinal metaplasia (IM) is a common gastric lesion that is considered premalignant. Our study aims to determine the relationship between normal white light endoscopy and histopathological IM diagnoses. This retrospective study evaluated the endoscopic prevalence and histopathological confirmation rate in 229 suspected IM patients among 3247 patients who underwent elective esophagogastroduodenoscopy between October 2016 and May 2020. All endoscopic processes were performed by the same clinical endoscopist. We analyzed and reviewed demographic data, endoscopic findings, and endoscopic biopsy pathology results of all patients obtained from medical records. The endoscopic prevalence of IM was 7.02. IM diagnosis was pathologically confirmed in 92.1% of the patients who were diagnosed with endoscopy. IM was more common in male patients (57.2%) than in female patients. Of the IM patients, 59% were aged ≥ 50 years, whereas 5.2% were aged ≥ 20-30 years and 22.7% ≥ 60-70 years. The incidence of Helicobacter pylori (H.pylori) was 40.2%. The endoscopic diagnosis of gastric intestinal metaplasia, which is a precancerous lesion, was in great agreement with histopathological diagnosis. However, the prevalence of endoscopic IM diagnosis was below that of histopathological diagnosis. IM diagnosis can be made more accurately by diligent and detailed endoscopic examination, particularly in older male patients.

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Efficacy of narrow-band imaging for detecting intestinal metaplasia in adult patients with symptoms of dyspepsia

Cited by 12 publications

References 38 publications

Narrow band imaging for detection of gastric intestinal metaplasia and dysplasia: A systematic review and meta‐analysis

Narrow band imaging for detection of gastric intestinal metaplasia and dysplasia: A systematic review and meta‐analysis

Image-enhanced endoscopy for gastric preneoplastic conditions and neoplastic lesions: a systematic review and meta-analysis

The Accuracy of Endoscopic Diagnosis of Intestinal Metaplasia Compared to Histopathological Diagnosis

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